Gutiérrez MM, Macías LJDJ, Ríos RDI

Language: Spanish
References: 11
Page: 333-335
PDF size: 1115.94 Kb.

ABSTRACT

A male patient in his fifth decade of life was admitted to the emergency department with abdominal pain localized in the right iliac fossa, accompanied by fever, nausea, three episodes of vomiting, and ten episodes of diarrhea. He was evaluated by the general surgery team, and due to the presence of an acute abdomen, the decision was made to perform an exploratory laparotomy plus appendectomy. He was transferred from the operating room with signs of refractory shock, requiring vasopressor support but without achieving a perfusion-target mean arterial pressure (MAP). Given the persistence of vasoplegia, methylene blue was initiated at a dose of 2 mg/kg. Hemodynamic improvement was observed after 8 hours, allowing for gradual vasopressor withdrawal and complete discontinuation at 72 hours. The patient developed green-blue urine and bluish skin discoloration as adverse effects, in addition to anuria requiring renal replacement therapy. Clinical improvement was achieved, with complete withdrawal of supportive measures by the 8th day.

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